What is endometriosis?
Endometriosis is a painful condition in which cells similar to the lining of the uterus (the endometrium) grow in other areas of the body, typically the pelvic region.
This abnormal tissue can irritate the surrounding tissues and organs, causing inflammation, pain, bleeding, the development of scar tissue (adhesions), infertility, and other issues, taking a significant toll on a woman’s health and well-being.
There is no cure for endometriosis. Specialized care is available to help:
- Accurately diagnose the condition
- Relieve pain
- Prevent the disease from worsening
- Preserve fertility
- Address other symptoms and health issues caused by endometriosis
Where does endometriosis occur?
The most common areas affected by endometriosis are the pelvic organs and structures, including:
- The female reproductive system (uterus, vagina, ovaries, fallopian tubes)
- The bladder and ureter
- The bowels and rectum
- The pelvic wall
- The pelvic nerves
Less frequently, endometriosis affects:
- The abdominal wall
- The diaphragm
- The liver
- Major blood vessels
- The lungs, brain, eyes and other vital structures and organs, to a lesser degree
What causes endometriosis?
The cause of endometriosis is unknown. Baylor Medicine researchers continue to gain new knowledge and insights into this complex condition to advance the detection, diagnosis, and treatment of endometriosis.
What are the risk factors for endometriosis?
Anyone with menstrual periods can get endometriosis, however, it is most common in women between the ages of 25 and 40. In the United States, the condition affects an estimated 11% of women between ages 15 and 44.
The risk is greater for women with a family history of endometriosis (mother, sister or aunt) and those with a history of painful periods.
Additional factors that may increase a woman’s risk include:
- Never given birth
- Periods occur frequently
- Long periods
- Short, frequent menstrual cycles
- Began menstruating at an early age
- Medical conditions that prevent menstrual blood flow
- Pelvic infections
While rare, endometriosis can also occur in individuals without a uterus or ovaries, and during menopause.
What are the symptoms of endometriosis?
Endometriosis is known for causing severe, often debilitating pain – the primary symptom. In the beginning, the pain occurs with the menstrual cycle, an important factor in diagnosing endometriosis. However, any occurrence of severe pelvic pain warrants further investigation.
Other signs and symptoms of endometriosis include:
- Painful periods that occur during and outside the normal menstrual cycle, with severe cramping, abdominal pain, and lower back pain
- Painful sex or pain after intercourse
- Pain with bowel movements or when urinating
- Abnormally heavy bleeding
- Bleeding between periods
- Difficulty getting pregnant
- A change in urinary habits (urgency or frequency)
- Abdominal bloating, nausea, constipation, diarrhea or other gastrointestinal (GI) issues
- Extreme fatigue
Endometriosis symptoms and their frequency vary from patient to patient. Many women with endometriosis don’t experience symptoms. The disease may not be diagnosed until the woman is unable to get pregnant. In cases of unexplained infertility, endometriosis is often the cause.
What are the stages of endometriosis?
Endometriosis is often classified into four stages generally defined as:
- Stage 1, minimal endometriosis – a few small, surface implants (areas of endometrial tissue), with little or no scarring
- Stage 2, mild endometriosis – more and deeper implants and possible scar tissue
- Stage 3, moderate endometriosis – more widespread endometriosis, deeper into the tissue, with significant scarring and adhesions and possible ovarian cysts (endometriomas)
- Stage 4, severe endometriosis – many deep implants, with most pelvic organs affected and possibly other organs, as well as large ovarian cysts, thick adhesions, possible anatomy distortion and infertility
There is no clear correlation between the stage of a woman’s endometriosis and their pain or infertility.